If human coronary artery is comparable to live wire , attempting bifurcation (BFL) stenting is akin to tame a live snake .True BFL (with Medina 1, 1, 1) being the most complex of all .The fact is ,we have atleast a dozen strategies for BFL with varying loads of metal abutting the ostia ,side branch and carina.This would essentially Imply we are still struggling with these lesions .

Obviously, not every interventional cardiologist can. Confidence is one thing , but , falling short of minimum standard of care is rampant in India. Newer Imaging tools, techniques are promising , unfortunately still the gap between, knowledge , science and reality continue to widen.

* Its true ,some expert Interventionists do a good job !

What is the simplest approach for Bifurcation lesions ?

We have come a long way in BFL. Still , some of the lesions can sting like a snake ! I am sure, everyone of us would have lost sleep after a complex BFL PCI !( Praying the humble heparin and DAPT to do the rescue act ! )

How to escape this double headed threat ?

A meticulous assessment of patient & lesion , mindfulness in choosing the hardware & Imaging , diligent usage of anticoagulants & DAPT and . . . finally willingness to listen to your own conscience , will ensure a gratifying result that includes abandoning the procedure !